Organization
METHODIST MEDICAL CENTER OF ILLINOIS
Active
Other names
MMG In School Health Peoria High
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M. CIRONE (REGIONAL MGR-REIMB/REV RECOGNITION)
(309) 672-4813
Entity
Organization
Contact information
Practice address
1615 N NORTH ST, PEORIA, IL 61604-4131
(309) 252-1020
(309) 281-1337
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0051
Taxonomy
Speciality
Code
Description
License number
State
363LS0200X
School Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/03/2018
Last updated
02/14/2020
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